Protective Effect of Wenyang Huoxue Huatan Prescription on Cardiotoxicity Induced by Anthracyclines / 中国实验方剂学杂志

Objective:To study the protective effect of the Wenyang Huoxue Huatan prescription （WYHXHT） on cardiotoxicity induced by adriamycin. Method:SD rats were randomly divided into the following six groups： a normal control group， an adriamycin model group， a low-dose （4.86 g·kg^-1） WYHXHT group， a middle-dose （9.72 g·kg^-1） WYHXHT group， a high-dose （19.44 g·kg^-1） WYHXHT group， and a dexrazoxane group. Except for the normal control group， the rats in other groups received intraperitoneal injection of 2.5 mg·kg^-1 adriamycin， once a week for six weeks， with a cumulative dose of 15 mg·kg^-1. The normal control group， the adriamycin model group， and the dexrazoxane group received 10 mL·kg^-1 normal saline daily by gavage. In the dexrazoxane group， the rats were subjected to intraperitoneal injection of 25 mg·kg^-1 dexrazoxane 30 min before doxorubicin administration， once a week for six weeks. The general condition of rats was observed and their body weight was monitored. A high-resolution micro-ultrasound imaging system was used to detect rat cardiac function. Hematoxylin-eosin （HE） staining was performed to observe the pathological changes of myocardial tissues of rats. Western blot was used to detect the protein expression of microtubule-associated protein 1 light chain 3 （LC3） Ⅱ， the mammalian homolog of yeast Atg6 （Beclin-1）， and p62 protein in rat myocardial tissues. Result:Compared with the normal control group， rats in the adriamycin model group showed dull fur， reduced food intake and activity， loose stool， low energy， and slow response. Besides， it also displayed reduced body weight （<italic>P</italic><0.01）， decreased left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） （<italic>P</italic><0.01）， myocardial cell degeneration， edema， rupture， and dissolution， expansion of myocardial interstitium， uneven staining of myocardial fiber， visible inflammatory cell infiltration， up-regulated expression of Beclin-1 and LC3Ⅱ in rat myocardial tissues （<italic>P</italic><0.01）， and down-regulated p62 expression （<italic>P</italic><0.01）. Compared with the adriamycin model group， the medium- and high-dose WYHXHT groups exhibited increased body weight， LVEF， and LVFS （<italic>P</italic><0.01）， relieved pathological injury of myocardial tissues， down-regulated expression of LC3Ⅱ and Beclin-1 （<italic>P</italic><0.05，<italic>P</italic><0.01）， and up-regulated expression of p62 （<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:WYHXHT can effectively prevent and treat adriamycin-induced cardiotoxicity， and its effect may be related to the inhibition of myocardial cell autophagy. The effect is dominant in the high-dose group.

Co-morbidity of vasovagal syncope and postural tachycardia syndrome with allergic diseases in children / 北京大学学报(医学版)

Objective:To explore the clinical characteristics of the co-morbidity of vasovagal syncope (VVS) and postural tachycardia syndrome (POTS) with allergic diseases in children.Methods:A retrospective analysis was launched to summarize the clinical data of children with VVS and POTS.They were divided into allergic group and non-allergic group according to the history of allergic diseases.The participants' clinical characteristics were compared between allergic group and non-allergic group using independent sample t test or rank sum test;composition comparisons were completed by Chi-square test.Bi-variate correlation analysis was used to explore the association between eosinophil percentage/count and symptom scores/frequency of syncope episodes.A P value ＜ 0.05 was defined as statistically significant.Results:Sixty-seven children complaining of orthostatic intolerance (43 patients diagnosed as VVS and 24 cases diagnosed as POTS) were enrolled.Totally 21 cases (31％) had allergic diseases,inclu ding allergic rhinitis,atopic eczema,asthma,as well as food allergy.And allergic rhinitis is the most common co-morbidity.There were no significant differences between the two groups in age,gender ratio,height,body weight and basement blood pressure.Compared with the non-allergic group,the allergic group showed later onset age (year) (11 ± 2 vs.9 ± 3,P ＜ 0.05) of orthostatic intolerance and shorter course of the diseases (month) [8.0 (0.1,0.1) vs.24.0 (0.1,144.0),P＜0.05].The frequency of syncope episodes in the allergic group among VVS children (times per month) [2.50 (0.08,30.00) vs.O.25 (0.03,5.00),P ＜ 0.05] was much higher than that in the non-allergic group.Additionally,the eosinophil percentage (％) [3.50 (0.70,0.59) vs.1.65 (0.30,6.20),P＜0.001] and eosino phil count (×109) [0.18 (0.05,0.71) vs.0.10 (0.02,0.38),P＜0.001] were increased in the allergic group.However,there were no remarkable differences in the results of head-up tilt test in children with VVS or in the maximum change of heart rate during standing test in children with POTS were involved.Conclusion:Allergic diseases are common co-morbidities in children with both VVS and POTS.Allergic rhinitis is the most common co-morbidity.Children with co-morbidity of VVS/POTS and allergic diseases had a later onset of symptoms of orthostatic intolerance,and were more likely to be hospitalized for intensive attacks of symptoms during a short period when compared with those without allergic diseases.Children diagnosed as VVS combined with allergic diseases had more frequent episodes of syncope.

The risk factors for ultrasound-diagnosed non-alcoholic fatty liver disease among adolescents

<p><b>INTRODUCTION</b>Non-alcoholic fatty liver disease (NAFLD) is garnering increasing interest and acceptance as one of the most important causes of chronic liver disease. The aim of this study was to investigate the risk factors for NAFLD among selected adolescent students in Hualien City, Taiwan.</p><p><b>MATERIALS AND METHODS</b>A stratified random sampling scheme was carried out among 1724 adolescent students aged 12 or 13 years old in Hualien City. In total, 220 students (normal: overweight: obese = 97:48:75) agreed to join the study. They underwent physical examination, laboratory tests and ultrasonography examination of the liver. Diagnosis of NAFLD in this study was based on sonographic evidence of a fatty liver and testing negative for serum HBsAg and anti- HCV antibody.</p><p><b>RESULTS</b>Of the 220 participants, 4 were excluded because they tested positive for HBsAg or anti-HCV antibody. NAFLD was detected in 86 (39.8%) out of the 216 subjects. The rate of NAFLD in the adolescents increased progressively from 16.0% in the normal group to 50.5% in the overweight group, and 63.5% among the obese subjects. Compared to their normal counterparts, adolescents with NAFLD had a significantly higher weight, body mass index (BMI), waist circumference, levels of alanine aminotransferase (ALT), triglyceride and nonhigh- density-lipoprotein (non-HDL) cholesterol. However, among the participants with NAFLD, only 20 (23.3%) showed ALT abnormality but there was an increasing trend of ALT abnormality as the severity of fatty liver increased. In addition, the higher ALT, Homeostasis model assessment- insulin resistance (HOMA-IR), cholesterol, triglyceride, and non-HDL levels and lower HDL-C as the severity of fatty liver increased. In a stepwise logistic regression analysis, the most significant factor associated with the presence of NAFLD was weight category. When compared with their normal counterparts, overweight and obese adolescents had a 4.14 and 5.98 times the risk of having NAFLD, respectively. Elevated ALT was the second most important factor as adolescents with elevated ALT were more likely to have NAFLD (odds ratio = 3.32, 95% CI: 1.16 to 9.50). Non-HDL cholesterol level was the third most important factor associated with NAFLD with a 3.81-fold increase in risk incurred for every l n (1 mg/dL) increment.</p><p><b>CONCLUSIONS</b>Obesity, ALT abnormality and elevated non-HDL-cholesterol are risk factors for NAFLD in adolescents. However, only 23.3% of the adolescents with NAFLD showed an abnormality for ALT. Therefore, ALT alone is not a sufficient indicator; and it is recommended that ultrasonography of the liver should be part of the routine health examination of obese adolescents.</p>